^ 



SF;257 




BULLETIN OF THE 



No. 1 




Contribution from the Bureau of Animal Industry, A. D. Melvin, Chief. 
September 17, 1913. 

MEDICAL MILK COMMISSIONS AND 
CERTIFIED MILK.^ 

By Ernest Kelley, 
In Charge of Market Milk Investigations. 

THE WORK OF MILK COMMISSIONS. 

The organization of milk commissions in this country was an im- 
!' portant step toward the improvement of the quality of milk. While 
the number of commissions is very limited and the milk produced 
under their supervision amounts to only a small proportion of the 
milk annually consumed, the great value of certified milk to invalids 
and its influence in reducing the mortality among infants and chil- 
dren are beyond estimation. Further, the work of milk commissions 
has had no little influence in improving the general milk supply of 
cities where such commissions exist, by setting a higher standard of 
quality and by creating public sentiment in favor of pure milk. 



THE FIRST COMMISSION: ITS ORGANIZATION AND OBJECTS. 

The beginning of this movement dates back to 1889, when the Medi- 
cal Society of New Jersey made an effort to improve the milk produc- 
tion in that State. A committee was appointed to make an investi- 
gation of the milk supply as far as it affected the public health. 
After two years' Avork this committee submitted a report condemning 
many of the methods employed in the production and handling of 
milk and advising an appeal to the State for a strict scientific super- 
vision of all the dairies within its limits. The appeal was made, but 
failed. AAHiile the need was admitted, the authorities pleaded lack of 
funds for making the changes suggested. 

This effort having met Avith defeat, another line of Avork was re- 
sorted to. The chairman, a Newark physician, presented a plan in 
1892 to the Practitioners' Club of that city whereby physicians might 
themselves supervise the production of milk and thus be perfectly 
sure of its purity. The requirements for the production of certified 

1 An extensive revision of Bulletin 104, Bureau of Animal Industry, Medical Milk Com- 
missions and the Production of C'ortiflorl Milk in the United States, by C. B. Lane, 1908. 

4999°— Bull. 1—13 1 



3 



Monograph 



2 BULLETIN 1, U. S. DEPAKTMENT OF AGRICULTURE. 

milk were given with the utmost detail. It was recommended that a 
milk commission be formed by physicians who should certify to the 
milk over their names provided the requirements were fulfilled. This 
plan was indorsed by the Practitioners' Club, and a search was begun 
for a dairy with equipment suited to such rigid regulations. A dairy 
was found which had already set such a high standard that the 
methods used could readily be accommodated to the requirements of 
the medical commission. 

Having secured a dairyman who was ready to bind himself by con- 
tract to conduct his dairy in accordance with the requirements, physi- 
cians from Newark, Orange, and Montclair were chosen to make up 
the first milk commission, which was organized April 13, 1893, and 
the production of what is known as " certified milk " was begun. 
This commission was named " The Medical Milk Commission of Essex 
County, New Jersey." Since this was organized about 65 others have 
been or are now being formed in various cities on a similar plan. A 
description of the first will therefore serve to give a general idea of 
milk commissions and their work. 

OBJECTS OF THE COMMISSION. 

The objects and requirements of the commission were stated as 
follows : 

The objects of tbis commission are to establisb correct clinical standards of 
purity for cow's milk ; to become responsible for a periodical inspection of the 
dairies under its patronage ; provide for chemical and bacteriological examina- 
tions of the product, and the frequent scrutiny of the stock by competent vet- 
erinarians ; to promote only professional and public interests. 

The following are three general requirements or standards for the milk : 
(1) An absence of large numbers of microorganisms, and the entire freedom 
of the milk from pathogenic varieties; (2) unvarying resistance to early fer- 
mentative changes in the milk, so that it may be kept under ordinary condi- 
tions without extraordinary care; (3) a constant nutritive value of known 
chemical composition, and a uniform relation between the percentage of fat^, 
proteids, and carbohydrates. 

THREEFOLD EXAMINATION BY EXPERTS. 

A chemist and a bacteriologist examine samples of the milk, which 

..they obtain themselves, twice each month, and report their findings 

to the commission. A veterinarian examines the cows twice a month 

and makes report. Eepresentatives of the commission in person 

make a monthly inspection of the dairy and report to the others. 

The veterinarian must show the milch cows to be in perfect health. 
The chemist must show the milk to contain the required amount of 
solids and to be free from all foreign matter. The bacteriologist must 
show the absence of all disease-producing bacteria and a minimum 
of bacteria of all sorts. Only in case all these reports are satisfactory 
does the commission certifv to the milk. 



D. OF D, 



A* 
<> \?»s MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 3 

^ ORIGIN AND MEANING OF THE TERM "CERTIFIED MILK." 

The term '' certified milk " originated with the member of the 
commission who formulated the plan. At the instance of the com- 
mission the word " certified " was registered by Mr, Francisco m the 
United States Patent Office on October 16, 1904, under registry No. 
25368, the object being to protect it from being degraded by dairy- 
men not under contract with a medical commission. It was dis- 
tinctly understood, however, that the use of the term should be 
allowed without question when employed by medical milk commis- 
sions organized to influence dairy work for clinical jDurposes, 

Dr. Henry L. Coit, of Newark, N, J., who has been called " the 
father of certified milk," gives t\\e following definition ^ of certified 
milk: 

Milk from a lower animal which has been certified by a medical milk com- 
mission appointed by a medical society, which certification is the monthly 
authorization for the commercial use of the term and which certificate is based 
upon the commission's investigation relative to the production of the milk 
showing that it conforms to the standards of quality and purity for certified 
milk and the methods and regulations for the production of certified milk, 
which standards of quality consist of a fresh milk, unchanged by either heat 
or cold, less than 24 hours old when sold, and which contains not less than 12 
per cent of total solids, with not less than 3.5 nor more than 5.5 per cent of 
fat, to which have not been added any other food principle, chemical substance, 
or preservative, which standards of purity for the milk consist of the low- 
est possible bacterial and dust-dropping content consistent with the highest 
possible practice of dairy hygiene, provided that the average numerical con- 
tamination is not above an average weekly count of 10.000 bacteria per cubic 
centimeter, and from which milk every known method has been employed to 
exclude pathogenic microorganisms, and which standards of purity are safe- 
guarded by a medical guaranty of the health and personal hygiene of every 
employee handling the milk and by a veterinary guaranty that the milk herd 
will not be a carrier of any disease to those using the milk for food; which 
methods and regulations for the production of certified milk are carried on in 
conformity with those adopted by the American Association of Medical Milk 
Commissions and are changed from time to time as the action of this associa- 
tion modifies the technique for the attainment of the standards of quality and 
purity for certified milk growing out of improved methods and regulations for 
its production. 

THE CONTROL OF DAIRIES. 

Some commissions — particularly such as have under their super- 
vision only one dairyman who both produces and distributes certified 
milk — enter into a binding contract with the dairymen. This con- 
tract contains a more or less complete and detailed statement of the 
conditions under which certified milk must be produced and mar- 
keted; specifies standards for composition and bacterial content of 

1 This definition is modified somewhat in view of the fact that at the sixth meeting 
of the American Association of Medical Milk Commissions changes were made in the 
chemical standards outlined by Dr. Coit, 



4 BULLETIN" 1, TJ. S. DEPAKTMENT OF AGEICULTUEE. 

the milk; provides for inspection of premises, examination of cows, 
and collection and analysis of milk samples ; and includes provisions 
under which the contract may be terminated by either party entering 
into it. 

Many commissions prefer not to have any contract with their 
producers and claim that it is superfluous and unnecessary. The 
producers understand well that if their milk does not come up to 
the requirements they can not sell it. However, in cases where there 
are contracts, commissions are not at all hasty in severing relations 
with a producer when his milk falls below requirements, but make 
more frequent inspections and lend every effort at such inspections to 
help the dairyman out of his trouble. In this way when a producer 
does have trouble he often writes to know when the commission can 
send a representative to help him out of his difficulty. The efforts 
of such commissions are therefore to help and cooperate closely with 
the producer. Some commissions feel safer in the work without a 
lengthy binding contract. This plan allows a certain latitude for 
meeting conditions as they arise, and the latter vary greatly at dif- 
ferent farms, even though the dairymen all produce milk well within 
the requirements and standards. 

REQUIREMENTS AND STANDARDS. 

There has been in the past considerable diversity as to the require- 
ments of the various commissions concerning the production of certi- 
fied milk. In the spring of 1912 a report was received from 58 milk 
commissions as to the standards which they had set for both chemical 
composition and bacterial content. 

The requirements for fat range from 3.5 up to 5 per cent, while 
the standards for total solids range from 12 to 14 per cent. By far 
the greatest number of commissions required that the bacterial count 
be kept below 10,000 per cubic centimeter, one of the commissions 
requiring a count under 5,000 in the wintertime. One commission 
allowed 15,000, one 20,000, and three 30,000 bacteria per cubic centi- 
meter. It has been generally recognized, however, by those connected 
with certified-milk Avork that a standard of 10,000 bacteria per cubic 
centimeter is that which is usually associated Avith certified milk. 

In order to make the requirements more specific and to unify the 
work of the various milk commissions, the American Association of 
Medical Milk Commissions appointed a committee to draw up tenta- 
tive standards which should be adopted by the association for the 
production and distribution of certified milk. The report of this 
committee was read and accepted at the meeting of the association 
held in Louisville, Ky., May 1, 1912, and the provisions of this report 
are looked upon as standard regulations for this product. These 
rules are reprinted in the appendix of this bulletin. 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 5 

METHODS AND WORK OF THE VARIOUS MILK COMMISSIONS. 

NUMBER OF COMMISSIONS AND WHEN ORGANIZED. 

As previously stated, the first milk commission was organized 
April 13, 1893. An effort has been made to get correct data as to 
when subsequent commissions were organized, but this has proved 
an exceedingly difficult thing to do. Several commissions have given 
two different dates of organization, which is rather confusing in 
compiling statistics. This is probably due to the fact that many 
commissions were in existence and then for some reason or other 
became inactive for one or more years and were afterwards reor- 
ganized and carried on the original work. Fifty-four commissions 
reported the dates of their organization, and from their answers the 
following table has been arranged : 



Year of organization. 


Commissions 
organized. 


Year of organization. 


Commissions 
organized. 


1893 


1 
1 
1 
1 
1 
3 
1 
2 


1905 . . 


2 


1896 


1906 


5 


1899 


1907 . . . 


6 


1900 


1908 


14 


1901 


1909 - 


7 


1902 


1910 


6 


1903 


1911 


2 


1904 


1912 


1 







The most rapid increase is seen to have taken place from 1906 to 
1908, and since that time the increase has somewhat fallen off. This 
falling off in the number of commissions organized is probably 
explained by the fact that the field is being better covered so that 
new commissions are less needed than formerly. 

Not only has this movement spread in this country, but two or 
three commissions have been formed in Canada which conform to the 
same standards as those in the United States. 

In order to obtain information as to the medical milk commissions 
a large number of circulars were sent out to the various commissions 
in the spring of 1912. Replies were received from about 65 commis- 
sions, and it was found that quite a large number of these had become 
inactive either through lack of demand for certified milk or because 
of inability to find dairymen who would submit to the regulations of 
the commission. 

NUMBER OF CERTIFIED DAIRIES AND QUANTITY OF MILK PRODUCED. 

The number of dairies producing milk for any one commission 
varies from 1 to 20. Several commissions were found to be still in 



6 



BULLETIN 1, U. S. DEPARTMENT OF AGEICULTUEE. 



existence and to have a full complement of officers, but not certifying 
any milk at the time of reporting. The following table shows the 
number of dairies certified by each commission : 



Dairies certified. 


Commissions. 


Dairies certified. 


Commissions. 


None 


20 

19 

10 

4 

3 


5 


3 


1 


6 


1 


2 


10 


1 


3 


12 


1 


4 


20 


1 









Out of ()3 commissions reporting as above, 20 had discontinued the 
certification of milk. The smallest amount certified by any one com- 
mission is 75 to 100 quarts a day, while the greatest amount which is 
passed upon by a single commission is 10,752 quarts a day. A few 
commissions certify cream as well as milk. Ninety-two certified 
dairies answered the question blanks sent out, and they report the 
total quantity of milk produced as 16,633 gallons a day. As there 
are about 125 certified dairies in all, it seems probable that the total 
production reaches 25,000 gallons. 

The 63 commissions answering the letter reported the certification 
of 12G dairies. A former investigation (Bureau of Animal Industry 
Bulletin 104) showed that on January 1, 1907, there were only about 
6,000 gallons a day of certified milk produced; so that in five years 
there has been an increase in the production of certified milk of about 
300 per cent. 

INSPECTED MILK. 

Several of the medical milk commissions are supervising the pro- 
duction of a si^ecial grade of milk which is called " inspected milk." 
This milk does not conform to all the requirements for certified milk, 
but is still of a high quality and much safer than the ordinary market 
milk of most cities. It is usually demanded that the cows kept for 
the production of this milk be free from tuberculosis and that the 
bacterial count shall be under 100,000 to the cubic centimeter. This 
milk sells for a less price than does certified milk, and is therefore 
within the reach of a larger class of consumers. One commission 
reports that it is inspecting 9 dairies in addition to those certified. 
The total number of " inspected " dairies reported was 20. The 
inspection of dairies seems to serve a double purpose, in that it not 
only puts a clean milk, which is produced under medical supervision, 
in the hands of the consumer at a reasonable price, but it also serves 
as a school for dairymen who may contemplate at some future time 
the production of certified milk. 



MEDICAL MILK COMMISSIONS AND CEKTIFIED MILK. 7 

INSPECTION OF DAIRY AND PRODUCT. 

The answers from the various commissions relative to inspections 
show considerable variation. In some instances the inspections are 
made by members of the commission and in others paid inspectors 
are employed to do the work. As a rule, inspections of the dairy 
are made monthly by either a veterinarian or a member of the com- 
mission, or both, and in some instances inspections are made every 
two weeks. The tuberculin test is usually applied annually, but in 
some cases this is done every six months. Chemical and bacteri- 
ological examinations range all the way from once a week to once in 
two months; in most instances, however, it is the practice to make 
tests every two weeks or oftener. 

HEALTH OF EMPLOYEES. 

The employees in certified-milk plants are required to be clean in 
habits and appearance and are not admitted to the stables or dairy if 
not in good health. Some commissions require that employees be 
regularly examined by a physician and given certificates of health. 
In some certified-milk plants attendants when ill are cared for in a 
building specially set apart for the purpose. 

PRECAUTIONS TO PREVENT SPREAD OF CONTAGIOUS DISEASES. 

Where a large milk business is conducted and several thousand 
customers are served daily, there is danger that some contagious 
disease may be brought into the dairy in some of the bottles. To 
avoid this, in some instances a wagon makes a special trip to collect 
bottles from any house where a contagious disease is known to exist. 
These bottles are thoroughly boiled in a special room before they 
come to the dairy proper. They are then subjected to the same 
cleansing process as all the others. 

SOME GENERAL CONSIDERATIONS. 

IS THE DEMAND FOR CERTIFIED MILK INCREASING ? 

Although there has been a remarkable increase in the quantity of 
certified milk produced between 1907 and 1912, it must be admitted 
that the demand is not as great as might be expected. In nearly all 
localities it is a hard fight for the milk commissions to educate the 
consumers to the consumption of certified milk. There are two main 
reasons for this. First, it has been found that there is a general 
apathy among consumers as to the purity of their milk supply. This 
would hold good as well with certified as with market milk. 
Another reason is that the price of certified milk is considerably 
higher than that of market milk, and it is hard to get people to pay 
the extra cost. Keports were received from 45 commissions as to the 



8 BULLETIN 1, U. S. DEPARTMENT OP AGRICULTURE. 

demand for certified mill^. Tliree of these were indefinite. Only 10 
out of this number reported that the demand was increasing rapidly; 
1 more stated that the demand was fair, 2 that the demand was 
increasing steadily, 2 that there was a moderate demand, and 4 that 
the increase was gradual. This gives a total of 19 commissions that 
found that the demand was increasing in a satisfactory manner. 
The other 23 ansAvers were divided as follows: Not a rapid increase, 
12 ; very slow, 1 ; slight increase, 2 ; slow increase, 7 ; limited, 1. 

It appears from these answers and from the results tabulated that 
while certified milk is increasing its sphere of influence, the increase 
is very slow, and at the present time only about one-half of 1 per 
cent of the total milk supply of this country is certified. One com- 
mission made the report that the demand was fairly good, but .no 
dairyman was willing to supply it. Another commission accounted 
for the slow increase in the demand for certified milk by saying that 
the use of certified milk was limited because of the superior quality 
of the market milk in the city wdiere the commission was located. 

PRICES OF CERTIFIED MILK COMPARED WITH THOSE OF MARKET MILK. 

The prices of certified milk to the consumer vary in different cities 
from 10 to 20 cents a quart, the average price for all cities being 
about 14.2 cents. The price of ordinary market milk in the same 
cities varies from 5 to 12 cents a quart and averages about 7.8 cents. 
Certified milk therefore sells for an average of 6.4 cents a quart more 
than market milk. As a rule, where the price of market milk is low, 
the price of certified milk is also comparatively low, although this 
does not hold true in all cases. 

It was found in 1907 that the average price of certified milk was 
12^ cents a quart, and the average price of market milk was 7^ cents 
a quart. It will be seen from the foi-egoing figures that while the 
average price of market milk has increased only about 0.6 of a cent a 
quart, the average price of certified milk has increased about 2 cents 
a quart. 

THE INFLUENCE OF CERTIFIED MILK. 

While certified milk is in a class by itself and does not enter into 
competition with ordinary grades of market milk, it has much edu- 
cational value in cities where it is used. There is no doubt that the 
advertising of certified milk does much to inform consumers that 
clean milk costs more than dirty milk and that a cheap milk is apt 
to be dangerous. 

The influence of certified milk on dairymen in general is a little 
more complex. Certified dairies have certainly shown how to pro- 
duce the finest grade of milk and have served as models along this 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 9 

line. An unfoitunate feature has been that many of them have been 
operated at a financial loss, and this has had a demoralizing effect 
upon many dairymen, who have been led to believe that the produc- 
tion of clean milk necessitates the outlay of large sums of money in 
expensive equipment. 

SO-CALLED CERTIFIED MILK NOT CONTROLLED BY MILK COMMISSIONS. 

There are a few dairymen who sell their product under the name 
of certified milk who have no connection with the milk commissions. 
These, in some cases, certify to their own product, and in others 
samples are sent to a State experiment station or to some local chemist 
or bacteriologist for examination. Some dairymen in this class supply 
a very creditable product. There are others whose mi-Ik is of only 
ordinary quality. Here, again, the samples for analysis are usually 
taken by the dairyman himself from milk fresh from the cow and 
immediately iced and sent to the analyst. The analyst reports his 
results and the dairyman uses them to advertise his product. This 
can not be looked upon as anything but a deception, as the consumer 
is given to understand that this is the analysis of the milk as it is 
delivered to him daily. It is only when medical milk commissions 
have been organized and a plan of education has been started to 
create a demand for sanitary milk designed for infant feeding that 
there arises any danger of an impure milk being put on the market 
under such a label. It is manifestly unfair, therefore, that after a 
commission, serving without pay in the interest of the public, has 
created a feeling that " certified " milk means a safe, clean milk for 
infant feeding, some unprincipled dairyman should be able to prey 
on the ignorance of the public and supply an unsafe milk at a high 
price. Some steps should be taken by the milk commissions or by 
city or State officers to prevent such practices. Where milk is an 
article of interstate commerce, however, tlie national pure-food law 
covers misrepresentations of this character. 

LEGALIZATION OF THE TERM "CERTIFIED MILK." 

The State of New York has set a good example in passing a law 
for regulating the sale of certified milk. A portion of the law r^^ads 
as follows: 

No person shall sell or exchange, or offer or expose for sale or exchange, as 
and for certified milk any milk which does not conform to the regulations pre- 
scribed by, and bear the certification of, a milk commission appointed by a 
counLy medical society organized under and chartered by the Medical Society of 
the State of New York and which has not been pronounced by such authority to 
be free from antiseptics, added preservatives, and pathogenic bacteria in exces- 
sive numbers. All milk sold as certified milk shall be conspicuously marked 
with the name of the commission certifying it. 

4999°— Bull. 1—13 -2 



10 BULLETIN 1, U. S. DEPARTMENT OF AGRICULTURE. 

New Jersey has also passed a very stringent law governing the 
production of certified milk. This act was approved by the gov- 
ernor on April 21, 1909, and a section of it reads as follows : 

11. No person, firm, or corporation shall sell or exchange or offer or expose 
for sale or exchange as and for certified milk any milk which is not produced 
in conformity with the methods and regulations prescribed by and which does 
not bear the certification of a medical milk commission, incoiporated pursuant 
to the provisious of this act or organized or incorporated in some other State 
for the pun:)oses specified in section 1 hereof, and which is not produced in 
conformity with the methods and regulations for the production of certified milk 
from time to time adopted by the American Association of Medical Milk Com- 
missions, and which is below the standards of pui'ity and quality for certified 
milk as fixed by the American Association of Medical Milk Commissions ; and 
any such person, firm, or corporation violating any of the provisions of this 
section shall be guilty of a misdemeanor. 

The State of Kentucky also defines certified milk in the following 
words : 

An act for preventing the manufacturing and sale of adulterated or mis- 
branded foods, drugs, medicines, and liquors and providing penalties for viola- 
tion thereof. 

Section 3, paragraph 3. If in the case of certified milk it be sold as or labeled 
" certified milk," and it has not been so certified under rules and regulations by 
any county medical society, or if. when so certified, it is not up to that degi'ee 
of purity and quality necessary for infant feeding. 

California has also passed a law governing certified milk, and 
several other States contemplate such legislation. 

Michigan has seen fit to recognize the importance of this subject 
and has passed a law which varies somewhat from the other laws. 
The Michigan act provides that any board of health having two or 
more physicians among its membership is authorized to appoint five 
physicians as a medical milk commission to supervi.se the production 
of certified milk. In towns not having a board of health so consti- 
tuted the State board of health may make the appointment. 

FINANCIAL SUPPORT OF MILK COMMISSIONS. 

Members of milk commissions rarely receive any pay for their 
work, their services being given gratis for the public good. Small 
expenses of the commission are usually met by the commission itself. 
Occasionally philanthropic subscriptions are received. In one city 
three men contributed $800 after an appeal by the commission. 
Postage, printing, and salaries of experts ape usually paid by the 
producers. 

There is no uniformity regarding the charges for certification. 
Some commissions make absolutely no charge, while others charge 
the actual expenses of the various inspections and examinations to 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 11 

the dairymen. The foUowino^ is a list of some of the charges made 
by different commissions at the present time : 

$40 a year for each dairy. 

$10 a month. 

$25 a year for each 100 cows. 

$8 a month for 100 quarts. 

$60 a year for each dairy. 

One per cent of the retail price. 

One-half the cost of the bacteriological examinations. 

$10 iier 1.000 caps. 

$5 per 1,000 caps. 

$4 per 1,000 caps. 

$3.50 per 1.000 caps. 

$1.25 per 1,000 caps 

One-third of a cent a quart. 

Oae-fourth of a cent a quart. 

Ono and one-half cents a quart. 

It would seem that the most equitable charo;e for certification would 
be by the sale of caps bearing the seal of the commission. This is 
done in a majority of cases, but, as can be seen, the charges vary over 
a wide field. 

THE AMERICAN ASSOCIATION OP MEDICAL MILK COMMISSIONS.' 

The spread of the certified milk movement was undoubtedly re- 
tarded because of the difficulties that presented themselves to those 
who had such an organization in contemplation. The subject was 
not broadly understood by the medical ]3rofession, and even when the 
organization of a milk commission was determined upon it was diffi- 
cult to arrive at the most acceptable plan of organization and detail 
of working methods. 

The usual procedure was to get into correspondence with one of 
the older commissions, which would relate its individual way of 
handling this problem. If the plan submitted seemed unsatisfactory, 
other commissions would be written to, and so an endless correspond- 
ence resulted, which proved especially burdensome to the Newark, 
N. J., commission. 

The secretary of the Cincinnati commission. Dr. Otto P. Geier, 
encountered this same difficulty at the period of organization of that 
commission. It resulted in his sending out a series of 24 questions 
covering every phase of activity in milk commission work. These 
were addressed to every commission then known. This very ex- 
haustive tabulation showed that there existed considerable lack of 
uniformity as to organization, working methods, supervision of 
dairies, chemical and bacteriological standards, methods of bottling, 
capping, and sealing, etc. 

1 The writer is indebted to Dr. Otto P. CJeler, secretary of the American Association of 
Medical Milk Commissions, for data regarding the organization of the association. 



12 BULLETIN 1, U. S. DEPAKTMENT OF AGRICULTURE. 

Out of this mass of correspondence an attempt was made to arrive 
at the most acceptable standards and working factors, and the con- 
chision was reached that a conference of the milk commissions would 
be most valuable to all concerned. 

In February, 1907. the Cincinnati commission addressed the various 
milk commissions suga;estino; a conference to be held in connection 
with the meeting of the American Medical Association at Atlantic 
Citv. Out of this grew a temporary organization. Dr. Henry L. 
Coit, Dr. Otto P. Geier, Dr. Samuel McC. Hamill, Dr. Kowland G. 
Freeman, Dr. William H. Park, and Dr. Thomas W. Harvey, acting 
as a committee, formulated a program and called the conference for 
June 3, 1907, at Atlantic City. 

This initial conference was remarkable in that delegates were pres- 
ent from 12 different States, representing 21 commissions in as many 
cities. Over 100 physicians and leading hygienists attended this 
meeting, and a tremendous amount of work was accomplished. Re- 
ports were read by delegates as to the work of their particular com- 
missions. Papers were presented on the broad topic of a pure-milk 
supply for cities. A permanent organization was effected, to be 
known as the American Association of Medical Milk Commissions, 
and the following officers were elected: 

President. Dr. Henry L. Coit 

Secretary, Dr. Otto P. Geier. 

Treasurer, Dr. Samuel McC. Hamill. 

Council: Dr. Rowland G. Freeman, chairman (5 years); Dr. Henry Enos 
Tuley (4 years) ; Dr. C. W. Brown (3 years) ; Dr. A. W. Myers (2 years) ; Dr. 
H. L. K. Shaw (1 year) ; and the president, secretary, and treasurer of the 
association. 

Committees were appointed upon every phase of activity in milk 
certification to investigate and report at the next annual meeting. 

It can be said that this meeting marked a new era in the pure-milk 
crusade. It is agreed that this organization is in position to crys- 
tallize the best thought that has been given to this subject, and that 
through such central organization quick dissemination of that 
knowledge will folloAv. 

The constitution of this association declares its object in the fol- 
lowing language : 

The purpose of this association shall be to federate and to bring into one 
compact association the medical milk commissions of the United States; to ex- 
change views and to adopt uniform methods of procedure in the work of the 
medical milk commissions ; to fix chemical and bacteriological standards ; to 
determine the scope of veterinary inspections; and to foster and to encourage 
the establishment of medical milk commissions in other cities. 

A better understanding of this subject will reveal the fact that 
milk commissions are widening their scope, and that through their 
activity the quality of the general supply of milk in the large cities 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 13 

is being elevated. It will show that it is practicable for any medical 
association to form such a commission, which, once formed, will be 
most useful in educating the public as well as the profession and in 
creating a demand for a cleaner milk supply, and will thus further 
the efforts of boards of health. 

THE PRODUCTION OF CERTIFIED MILK. 

EQUIPMENT AND METHODS. 

In the following pages is given a short description of the equip- 
ment and methods that are used at the present time among the various 
dairies that produce certified milk. 

The Dairy Division is ready at any time to furnish working blue 
prints for the construction of barns and milk houses in wdiich certified 
milk may be produced and handled. 

STABLES. 

The stables in which the cows are housed for the production of 
certified milk are built of various materials and vary greatly as to 
their arrangement and cost. In the past certified stables have been 
built mostly of wood or brick, but of late there have been a few 
stables erected entirely of concrete. Feeding floors, walks, and gut- 
ters are nearly always built of cement, and in a number of cases the 
platform on which the cows stand is also built of this material. 
Some certified dairies use wood for this purpose, and a few are using 
cork brick for the cows to stand on. 

AlHiile many of the certified barns at the present time are built 
with a storage loft for feed overhead, it is thought that the best 
practice is to have the cows in a separate one-story structure. 

A great deal of money has been spent in some certified-milk plants 
in finishing the stable in an elaborate manner w^th tile and expensive 
trimmings. Experience would seem to show that good results can 
be secured in an inexpensive barn, provided the proper precautions 
are observed. The floors should be smooth, nonabsorbent, and easily 
cleaned ; the gutters should be capacious ; the walls and ceilings should 
be absolutely smooth so that they may be easily kept free from dust 
and other dirt. Square corners and ledges should be avoided. The 
barns which are most easily kept clean are built with rounded corners 
and no horizontal ledges where dust may accumulate. It facilitates 
work if running water is available in a barn, so that the floors and 
walls may be washed down with a hose. 

At least 500 cubic feet of air space and 4 square feet of window 
glass per cow should be allowed. Many certified stables are built 
with a much greater window allowance. Sunlight acts as a disin- 
fectant in the stable and adds much to the attractiveness of the 
building. 

Views of stables are shown in Plates I and II. 



14 BULLETIN 1, V. S. DEPARTMENT OF AGRICULTURE, 

DAIRY HOUSES. 

Milk houses on certified farms vary almost as greatly as do the 
stables. Stone, brick, wood, and cement are used for their construc- 
tion. The same rules regarding the absence of ledges and the smooth- 
ness of the walls, floors, and ceilings should be observed. An entirely 
separate room should be provided for handling the milk, and in the 
majority of certified dairies this room is kept tightly closed while milk 
is being bottled and no visitors are allowed access to it. In some of 
the milk rooms air is supplied through a filter, so that there is no 
danger of bacteria being admitted from the outside air. Screens 
should be provided for all openings in the milk house, and there is 
no excuse for flies in the milk room. 

HEALTH AND CLEANLINESS OF CATTLE. 

The medical milk commissions require the tuberculin testing of 
the herds under their supervision. In addition, any cows showing 
abnormal symptoms or any form of disease which might atfect the 
milk are eliminated from certified herds. The cattle are carefully 
groomed at least once a day so that there can be no accumulation of 
filth upon them, and in many dairies the cows' tails are washed 
daily. Many certified-milk producers are in the habit of clipping 
the hairs from the udders, flanks, legs, and bellies of all the animals, 
so that they are the more readily kept clean. A few certified dairies 
have installed vacuum cleaners with which the cow^s are cleaned 
previous to milking. These cleaners take up much of the dust, loose 
hairs, and scurf which would simply be brushed into the air of the 
stable by hand cleaning. After the cows are cleaned they are fas- 
tened so that they can not lie down until the milkers are through. 

REMOVAL OF MANURE. 

Wherever practicable the manure should be carried to the field 
daily. Many dairies follow this custom and find it economical, in 
that the manure does not have to be handled twice, as it would were 
it kept in a pit. At other dairies covered pits are built for the re- 
ception of the manure. "\A'Tiere these are built they should be of 
water-tight construction and should be tightly screened and covered 
to keep out flies. 

BEDDING. 

"V^Hiile straws is used for bedding in some of the certified dairies, a 
large number use either planer shavings or sawdust. Baled shav- 
ings may be had at a nominal price and make a ver}'^ satisfactory 
bedding in sanitary dairies. As fast as these shavings are soiled or 
become damp they should be removed with the manure and replaced 
with clean, dry shavings. 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 15 

FEEDING. 

On account of the dust and odors which arise from the feedintj 
of hay. 2frain, and silage, nearly all certified dairies prefer to do the 
feeding after milking has been completed. 

BARNYARD. 

The barnyard should be well drained and kept free from all filth. 
If good natural drainage can not be secured it is sometimes necessary 
to fill in the barnyard Avith coal ashes, gravel, shells, or some other 
drainage material. Sometimes underdrains are put in to carry away 
superfluous moisture. As the cows often lie down in the l)arnyard, 




Pig. 1. — Ordinary milk pail made into a small-top pail by the addition of a hood. 

it is important to keep the yard clean, so that they may not become 
unnecessarily dirty. 

UTENSILS. 

Particular attention is paid by certified dairies to the construction 
of the utensils which come in contact with the milk. It is most de- 
sirable to have the utensils as free as possible from all crevices and 
inaccessible parts. The simplest utensils are the ones which are the 
most readily cleaned, and hence the danger of contamination from 
them is less. Small-top milk pails are used by practically every 
certified dairy. There are many forms of the small-top milk pail 
in use at the present time, and it is generally known that these pails 
are responsible for the elimination of many bacteria from milk. 
Figure 1 shows a small-top pail Avhich can be made from an ordi- 
nary milk pail by the addition of a hood. This pail will take the 
place of some of the more expensive kinds and do very satisfactory 
work. 



16 BULLETIN 1, U. S. DEPAETMENT OP AGRICULTURE. 

In considering the purchase of a sanitary milk pail two things must 
be considerecl — first, its practicability, and, second, the ease with which 
it can be cleaned. Some of the so-called sanitary pails have proved 
to be too cumbersome and unwieldy for practical use, while others 
have spouts, sharp angles, and inaccessible places that are extremely 
difficult to clean. It is usually the practice to fill all of the seams and 
corners in milk utensils with solder, so that a smooth, cleanable 
surface is presented. 

At practically all of the certified dairies steam is used for the 
sterilization of utensils^ including bottles, cans, milk pails, strainers, 
and in some cases even the coolers and bottle fillers. This sterilization 
is done in large ovens, which can be bought ready-made or can be 
built by the owner of the plant. (See PI. IV, fig. X2») In these 
sterilizers the utensils are sterilized with live steam, usuady for a half 
hour and sometimes under a slight pressure. These sterilizers are con- 
structed of cement, brick, iron, and in one dairy the sterilizer in use 
is lined with glass enamel, which makes a smooth, cleanable surface. 
In many certified dairies the custom is practiced of sterilizing the 
milk pails and other utensils and leaving them inverted in the steri- 
lizer until milking time. This protects them from contamination due 
to flies or impure outside air. 

PREPARATION FOR MILKING. 

At all certified dairies great care is exercised to see that the stable 
air is free from dust and odors at milking time. The cows are 
groomed and the floors are swept long enough before milking so that 
the dust has had a chance to settle. Some dairies make a practice of 
spraying the air in the barn and the bedding with a fine spray of 
water just previous to milking, so that all dust particles are laid. 
At one dairy this result is achieved by the use of steam. Pipes 
pierced with holes run horizontally through the barn, and just before 
milking steam is turned into them. One disadvantage of this method 
is that it raises the temperature in the barn considerably in the sum- 
mer time. Before milking, the cows are usually cleaned by a separate 
gang of men. In a few places the milkers wash the cows just before 
they milk them, but this is not considered so satisfactory on account 
of the fact that the milkers' hands are apt to be contaminated from 
the wash water, and imless they are careful to clean them each time 
there may be bad results. The cow-cleaning gang usually consists of 
three or four men, who thoroughly prepare the cows for the milkers. 
One of these men sometimes uses a damp towel or a piece of sacking 
with which he wipes off the body of the cow to remove any loose hairs 
or dust which have not been removed by previous grooming. Then 
the cow's udder and flanks are washed, usually in two separate waters, 
care being taken to change the w^ater often enough so that it does 



Bui. No 1, U. S. Dept. of Agriculture. 



Plate I. 




Exterior Views of Dairy Stables where Certified Milk is Produced. 



Bui, No. 1, U. S:Dept. of Agriculture. 



Plate II. 




Interior Views of Dairy Stables where Certified Milk is Produced 



Bui. No. 1, U. S. Dep^ of Agriculture, 



Plate III. 




Steps in the Production and Handling of Certified Milk. 

1 Clipping cows. 2. Clenning cows. 3. Washing cows preparatory to milkin 
4. Milker washing hands. 5. Milking. 6. Cooling and bottling. 



Biil. No. 1, U. S. Dept. of Agriculture. 



Plate IV. 



■ 




Steps IN the Handling and Delivery of Certified Milk. 

7. Sealing bottles. 8. Storage. 9. Case of bottles ready for delivery. 10. Delivery wagon. 
11. Washing bottles. 12. Sterilizing bottles." 



Bui. No. 1 , U. S. Dept. of Agriculture. 



Plate V. 




MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 17 

not do more harm than good. In some certified dairies a disinfectant 
is used in this water, but in the majority of cases plain water is used. 
After washing,, the cows are usually partially dried with a clean 
towel, the object being to have the cows' hides slightly moist, but not 
wet enough for any moisture to run on the milkers' hands or drip 
into the pail. 

While the cows are being prepared the milkers assemble in the 
dressing room and put on their clean milking suits and thoroughly 
scrub their hands and finger nails with soap and brushes. In a few 
dairies the requirements for the cleanliness of the milkers are so rigid 
that only smooth-shaven men are allowed to milk the cows or have 
anything to do with handling the milk. ^Vlien the milkers are satis- 
factorily prepared for milking they' are handed sterilized milk pails 
and milking stools and allowed to start work. In some dairies the 
cows are milked in a room separate from the stable. This room holds 
only a few cows at a time, the cows being cleaned in the main barn 
and led into the milking room to be milked. Judging from the bac- 
terial counts of the various dairies there is nothing specially gained 
by this, if proper precautions are taken in the main barn. 

MILKING. 

In a few dairies the milkers use a little vaseline on the hands while 
milking, but in practically all cases milking is done with dry hands. 
It is very often the practice to discard the first few streams of milk 
from each cow, which are drawn into a cup. This " foremilk " con- 
tains large numbers of bacteria, and the count can be^ reduced by re- 
jecting it. 

Milkers are instructed to milk quickly and quietly, and after each 
cow is finished they carry the milk to the straining room, where it is 
strained and cooled immediately. By far the best method is to re- 
quire the milkers to wash their hands after milking each cow. 
Plenty of clean towels should be provided for the purpose of wiping 
the milkers' hands. In one dairy paper towels are being used, so 
that perfectly fresh unused towels are at hand for each milker. 
During the milking the milkers should not be allowed to rest the 
milk pail on the floor, as the bottom of the pail is liable to become 
covered with dirt, which is transferred to the milkers' hands when 
he pours the milk from the pail. 

SUBSEQUENT HANDLING OF MILK. 

The milk is removed immediately from the barn to the milk 
house, where it is cooled and bottled at once. In some dairies the 
milk is bottled warm and the bottles are packed in ice or stood in ice 
water. This eliminates much exposure to the air. Various types 
of bottle fillers are in use in the large dairies, while one or two of 
4999°— BulL 1—13 3 



18 BULLETIN 1, U. S. DEPAKTMENT OF AGEICULTUEE. 

the very smallest fill the bottles from a large clipper or pitcher. In 
the last few years capping machines have been perfected so that the 
bottles may be filled and capped without being touched by human 
hands. This is a decided advantage, as the old method of placing 
the caps in the bottles by hand was liable to result in serious con- 
tamination. Practically all of the certified establishments sterilize 
the caps which are used in the milk bottles. This sterilization is best 
accomplished by dry heat, as steam is apt to swell the x)aper caps so 
that they do not fit the capping machine or the neck of the bottle. 
The caps are placed in a small cylinder or rolled in brown paper and 
placed in dry ovens, where they are heated for about an hour. 

Practically all certified-milk dairies now use some sort of an out- 
side cover to protect the mouth of the bottle from being infected 
with dust or dirty water. A variety of appliances for this purpose 
are in use, some of which are shown in Plate V. 

TRANSPORTATION AND DELIVERY. 

Great care is taken to see that certified milk is always kept cold. 
It is cooled in the dairies by ice water, brine, or direct expansion 
almost down to the freezing point, and from that time until it is 
delivered to the consumer it is kept well packed in ice to prevent the 
multiplication of bacteria. 

The distribution of certified milk is done in some cases by the pro- 
ducer, but very often the producer ships to some retailer in the city, 
who handles the product for him. 

Some certified dairies maintain laboratories in charge of physicians 
or trained nurses where certified milk is modified for infant feeding 
according to physicians' prescriptions. The modified milk is put up 
in nursing bottles, sufficient feedings for one day being prepared at a. 
time and delivered to the consumer in a refrigerator case. 

INFORMATION SECURED FROM PRODUCERS. 

In order to secure accurate data relative to the production of cer- 
tified milk, a list of questions w^as sent to owners and operators of 
certified-milk farms. Answers were received from a large number. 
It was found that quite a number had discontinued the production of 
certified milk for one reason or another, several having stoppetl 
because of the lack of sufficient markets for their product or because 
the production was attended with financial loss. Answers to the 
questions were received from 92 dairies, distributed among IT States. 

NUMBER AND BREED OF COWS. 

The number of cows in herds producing certified milk varies from 
1> to 600. It was found that the average number of cows in certified 
dairies was 88. Practically every breed is represented in these herds. 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 19 

Some grade or native stock is found in most of them. There, are 
several herds of registered animals. The breed is not considered of 
special importance with most of the commissions, provided that the 
composition of the milk produced is within the limits of the stand- 
ards prescribed. Provided that the health of the animals is perfect, 
it makes very little difference apparently what the breed is. 

QUANTITY AND QUALITY OF THE MILK. 

The amount of certified milk produced daily by certified dairies 
ranged from 12^ to G.OOO quarts. The average daily production per 
dairy was found to be 747^ quarts. The average production of all 
the cows of all the dairies reporting is somewhat higher than that 
found in market milk dairies, but it is still far too low. An average 
of all the answers received shoAved that the production amounted to 
8.3 quarts of milk per cow per day. The fat in the milk as reported 
varies from 3.2 to 6 per cent, and averages about 4,3 per cent. 
This is a slightly lower average than was found in the investi- 
gations made in 1907. The total solids as reported by the various 
dairies ranged from 11.74 to 14.5 per cent, with an average for all 
dairies of an even 13 per cent. 

BACTERIA IN THE MILK. 

The average bacterial counts of the milk from the dairies reporting 
varied considerably. One dairy claimed that their count ranges from 
absolutely sterile plates up to 1,000 bacteria per cubic centimeter. 
Three dairies reported counts of 20,000. The average bacterial count 
of all the dairies reporting was 4,069 per cubic centimeter. Some 
extremely low averages were reported, one dairy having an average 
count for one yea^v of G55 bacteria per cubic centimeter. Still an- 
other dairy reported a seven weeks' average of 600 bacteria per cubic 
centimeter. 

RETAIL PRICES OF CERTIFIED MILK. 

The producers' reports on the retail price of their product shows 
that the lowest price received is 10 cents a quart, which price was 
reported by four dairies. The highest retail price was 20 cents a 
quart, which is received by two dairies. Averaging all the replies, 
it was found that the average retail price of certified milk is 14.3 
cents a quart. 

AGE OF MILK WHEN DELIVERED. 

Milk commissions huxe striven for the delivery of certified milk 
as soon after it is produced as possible ; all other things being equal, 
the sooner it is delivered and consumed the better. In answer to 
the question as to the average age of certified milk when delivered, 
92 producers returned answers which showed that some milk was 



20 BULLETIN 1, U. s. DEPAKTMENT OF AGRICLTLTUEE. 

delivered within 6 hours after its production, while some was not 
placed on the market until it was 48 hours old. The avera^je age 
when delivered w\as 20 hours. As some of this milk will not be used 
until 24 hours after its delivery, it is possible for some certified milk 
to be consumed after it is 72 hours old. 

SANITARY CONDITION OF CERTIFIED-MILK DAIRIES. 

In the past about 37 certified farms have been scored by represent- 
atives of the Dairy Division. An average of all these scores shows 
that the condition of certified-milk farms is about 90 points out 
of a j^ossible 100. This is a remarkably good showing, in view of the 
fact that to attain a mark of 100 conditions must be absolutely per- 
fect in every respect ; that is, that not a speck of dust or dirt could be 
found on the cattle or in the stables or milk house and that every- 
thing else was above criticism in every respect. That certified 
dairies have maintained a high standard is evidenced by the com- 
parison of their standing with the scores of ordinary dairies in gen- 
eral. Dairies supplying market milk to various cities in this country 
have been scored and will average between 40 and 45, depending 
upon the section of the country and the efficiency of the inspection 
system which governs them. A total of 953 dairies, the scores of 
which were filed in this division in one year, show an average score 
of 41.0 out of a possible 100 ; so that it will be seen that the average 
certified dairy scores more than twice as high as the average market- 
milk dairy. The lowest score of a certified-milk dairy of which there 
is any record in this department is 73.6. 

QUALITY OF CERTIFIED MILK. 

An index to the quality of certified milk is the result of complete 
analj^ses and examinations of this product at various milk contests, 
descriptions of which will be found in Bureau of Animal Industry 
Circular 205. Eighty-nine samples of certified milk and cream were 
scored in these contests, and the average score was 87.90 for certified 
milk and 87.82 for certified cream. The greatest fault in these sam- 
ples was that relating to flavor and odor rather than to the bacterial 
count. AVlien it is realized that in order to score perfect on bacterial 
count in these contests the average number of organisms found must 
be less than 400 to the cubic centimeter, it will readily be seen that 
certified milk has maintained a high standard as regards quality. 
Certified milk and cream both scored considerably higher than did 
milk and cream in the market classes. The average bacterial count 
for all the samples of certified milk submitted in these contests was 
between 7,000 and 8,000 to the cubic centimeter. It must be remem- 
bered that many of these samples were prepared especially for the 



MEDICAL MILK COMMISSIONS AXD CERTIFIED MILK. 21 

contests, SO that they indicate a knowledore of dairy sanitation and 
do not necessarily mean a uniform product of the same high quality. 

KEEPING QUALITIES OF CERTIFIED MILK. 

As would naturally be expected, certified milk with its si»ftll num- 
ber of bacteria will keep sweet for a long time. The theory that clean 
milk should have a long keeping quality works out in practice. In- 
stances are on record where certified milk has been taken on an ocean 
voyage and not only brought back in good condition but kept sweet 
until 30 days old. In fact, it is now a common practice for people 
when crossing the water or taking a long land journey with infants 
to take several cases of certified milk with them. They are then rea- 
sonably sure of having a constant supply of sweet milk for several 
days. This has been a great convenience and has given comfort to 
many people. 

A number of certified-milk dairies in the United States sent exhibits 
of milk to the Paris Exposition in 1000. The milk kept perfectly 
sweet for two weeks and in some instances 18 days after being bot- 
tled and after a summer journey of 3,000 to 1,000 miles. Eegular 
deliver}^ bottles w^ere used^ the only extra precaution being to use two 
pajjer caps instead of one, and to cover the caps with paraffin so as to 
exclude the air. Of course the milk was carefully packed in ice for 
shipment, but this was the only means used for preservation. 

The milk and cream contests at the National Dairy Show^ in recent 
3^ears have demonstrated the renuirkable keeping qualities of certified 
milk. Some of the samples submitted have come to Chicago from 
as far as the States of ^Yashington and California, and from various 
parts of Canada. Though these samples have some of them been 
over a week old when plated, they have show^n remarkably low" bac- 
terial counts, in some instances the count being less than 1.000 per 
cubic centimeter. After this milk has been judged it has been kept 
in cold storage, and some has been consumed over two weeks after its 
joroduction, when it was found perfectly palatable and apparently 
unchanged in any way. 

However, it is not advisable to use old milk even though it may 
taste sweet. Serious consequences may result due to bacterial growth 
wdiich can not be detected in the flavor of the milk. 

IS THE PRODUCTION OF CERTIFIED MILK PROFITABLE? 

At the present time the unqualified statement can not be made that 
the production of certified milk is a profitable venture. Seventy- 
four certified-milk producers answered the questions sent out by the 
Dairy Division as to the profitableness of certified-milk production, 
and their answers may be grouped as follows : Unprofitable, 33 ; 
profitable, 22; not very profitable, 1; fairly profitable, 11; condi- 



22 BULLETIN 1, U. S. DEPARTMENT OF AGEICULTUEE. 

tioiial answers, 4. The conditional answers included 3 which 
stated that the business was profitable only part of the time, and 1 
which stated that it would be profitable if the markets for the prod- 
uct were larger. These answers can not be considered as favorable 
to the profitable production of certified milk, so a regrouping would 
give: Profitable, 37; unprofitable, 37. 

Oiit of the 37 dairies which are classed as profitable there are 15 
wdiich state that the business is not very profitable or only fairly so. 
There is very little doubt that certified milk can be produced and sold 
at a fair profit, as this is being done by many dairies at the present 
time. However, the large" number of unprofitable dairies shows that 
there is need for a radical change in the methods of many of the farms 
which are producing this class of milk. It is unquestionably the fact 
that many certified-milk producers can lower the price of production 
by applying better business principles to their operations, and this 
will undoubtedly result in a swinging of the balance from loss to 
profit on their books. 

OBSTACLES TO THE PROFITABLE PRODUCTION OF CERTIFIED MILK. 

To support the statement that some certified dairies are run under 
lax business methods, it is only necessary to point to a few figures 
received by this department. For instance, one dairy reports that the 
retail price of milk is 20 cents a quart, the average bacterial count is 
4,000 per cubic centimeter, and that the business is not profitable and it 
would require a retail price of 25 cents a quart to make it so. Another 
dairy states that the retail price is only 12 cents, the bacterial count 
3,000 (less than in the case of the other dairy), and that the business 
is profitable. There is a difference of 8 cents a quart "in favor of the 
first dairy, and yet with that advantage it is unable to conduct the 
business at a profit. 

Many certified-milk producers have erected extremely elaborate 
buildings, the interest and depreciation on which are so high that they 
form a considerable item to be charged against the cost of production. 
The interest and depreciation on a simple, inexpensive certified plant 
is estimated to amount to at least G cents a gallon, or li cents a quart. 
In some of the more elaborate plants, where much money has been 
spent for ornamental equipment, the interest and depreciation would 
be much higher. Experience in the past has proved that the produc- 
tion of clean milk is not dependent upon expensive equipment so 
much as upon care and vigilance concerning the methods of produc- 
tion. It is a well-known fact in business that a manufacturing plant 
can not afford to turn out such a small quantity of goods that the 
interest and depreciation on the factory will be too heavy a tax on 
the goods sold. Applying this same principle to dairying, it is almost 
impossible to see where some of the small dairies can afford to operate 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 23 

as they do. One dairy reports that they are selling only 12| quarts 
of certified milk a day, and the interest and depreciation on the 
capital invested in this plant will certainly amount to quite a large 
item per quart on all the milk sold. Another plant reports a daily 
selling- of 30 quarts, and another of only 120 quarts. 

The average production of milk per cow in certified dairies shows 
that many unprofitable animals are probably being kept, and a thor- 
ough system of record keeping should be inaugurated in order to 
weed out the low producers. One dairy reports that the average test 
of the milk is 6 per cent fat, and it is hard to see how such milk can 
be profitably sold in competition with 4 per cent milk. In order to 
improve the herds from year to year calves should be raised from 
the best producing cows. Here again is another item of added 
expense on the certified dairy, as the raising of calves is an expen- 
sive proposition, especially where milk valued at from 15 to 20 cents 
a quart is used. If calves are not raised and cows are bought from 
the outside there is little chance of bettering the herd. 

On most certified farms a higher class of labor is utilized than 
on the ordinary dairy farm. Many college graduates are employed 
as foremen, managers, or bacteriologists, and such men usually 
command higher salaries. 

Markets for certified milk at the present time are not developed 
sufficiently. Several of the certified dairies reporting that the pro- 
duction of this product was unprofitable intimated that if more milk 
could be sold and the plant oj^erated at a greater capacity a profit 
might be realized. The general public so far has very little idea as to 
what certified milk really is, and an educational campaign might 
well be carried on by the producers. In addition to this, lax methods 
on some farms have necessitated a high price for certified milk, and 
this has cut down the consumption considerably. 

There seems to be little uniformity regarding the distribution of 
certified milk. Some of the methods now in vogue seem to be to the 
disadvantage of the producer. Of the producers reporting, 25 retail 
the product of their dairies, while 17 do not. From the answers re- 
ceived it appears to be more economical to distribute through a mid- 
dleman, especially where the points of production and distribution 
are widely separated. The middleman has the advantage of already 
maintaining an establishment in the city and of running regular retail 
routes on which the certified milk can be distributed quite economi- 
cally. Some of these distributers of certified milk seem to charge the 
producer a rather high rate for their services. Many city dealers buy 
market milk from farmers and receive from 11 to 19 cents a gallon to 
cover the cost of freight, bottling, and distribution, besides giving 
them their profit. Certified milk is nearly alwa3^s bottled at the 
farm, so that the expense of handling in the city is much smaller. 



24 BULLETIN 1, U. S. DEPARTMENT OF AGRICULTURE. 

Figures submitted to this department, however, show out of 50 cents 
a gallon paid by consumers for certified milk from one farm, the pro- 
ducer got 26 cents, the freight was 4 cents, and the middleman 
charged 20 cents a gallon for his services in distributing the product. 
Another dairy receives 12 cents out of a retail price of 15 cents a 
quart, leaving the distributer 12 cents a gallon. In one case the mid- 
dleman received 5 cents a quart for distribution, Avhile the other re- 
ceived 3 cents. 

THE FUTURE OF CERTIFIED MILK. 

There is no doubt that from a sanitary standpoint certified milk 
is constantly improving, and it will undoubtedly continue to lead all 
classes of milk as a food for infants. It seems almost imperative, 
however, that business principles be more closely a]3plied to the pro- 
duction of certified milk, so that the price may be kept as low as pos- 
sible to the consumer and still let the farmers operate at a profit. 
Upon this one factor depends much of the future growth of the 
movement. It is very probable that certified-milk producers in the 
future will apply the same degree of intelligence and care to the 
economic features of their business as they have in the past to the 
sanitary side. 

THE CERTIFIED MILK PRODUCERS' ASSOCIATION. 

In order to disseminate information among themselves concerning 
methods employed in the production of certified milk, producers of 
this class of dairy products have formed an organization under the 
name of The Certified Milk Producers' Association of America. 
Yearly meetings are held at which papers are read which deal with 
the production of certified milk, both from a financial standpoint and 
concerning sanitation. 



APPENDIX 



METHODS AND STANDARDS FOR THE PRODUCTION AND DISTRIBU- 
TION OF CERTIFIED MILK. 

(Adopted by the Americau Association of Medical Milk Commissions. May 1, 

1912. ) 

HYGIENE OF tHE DAIRY. 

UNDER THE SUPERVISION AND CONTROL OF THE VETERINARIAN. 

1. Pastures or paddocks. — Pastures or paddocks to which the cows have access 
shall be free from marshes or stagnant pools, crossed by no stream which 
might become dangerously contaminated, at sufficient distances from offensive 
conditions to suffer no bad effects from them, and shall be free from plants 
which affect the milk deleteriously. 

2. Surroundings of huildings. — The surroundings of all buildings shall be kept 
clean and free from accumulations of dirt, rubbish, decayed vegetable or animal 
matter or animal waste, and the stable yard shall be well drained. 

3. Location of buildings. — ^Buildings in which certified milk is produced and 
handled shall be so located as to insure proper shelter and good drainage, and 
at sufficient distance from other buildings, dusty roads, cultivated and dusty 
fields, and all other possible sources of contamination; provided, in the case of 
unavoidable proximity to dusty roads or fields, the exposed side shall be screened 
with cheesecloth. 

4. Construction of stahlcs. — The stables shall be constiucted so as to facili- 
tate the prompt and easy removal of waste products. The floors and platforms 
shall be made of cement or other mmabsorbent material and the gutters of 
cement only. The floors shall be properly graded and drained, and the manure 
gutters shall be from 6 to 8 inches deep and so placed in relation to the plat- 
form that all manure will drop into them. 

5. The inside surface of the walls and all interior construction shall be 
smooth, with tight .joints, and* shall be capable of shedding water. The ceiling 
shall be of smooth material and dust tight. All horizontal and slanting surfaces 
which might harbor dust shall be avoided. 

6. Drinldng and feed troughs. — Drinking troughs or basins shall be drained 
and cleaned each day, and feed troughs and mixing floors shall be kept in a 
clean and sanitary condition. 

7. Stanchions. — Stanchions, when used, shall be constructed of iron pipes or 
hardwood, and throat latches shall be provided to prevent the cows from lying 
down between the time of cleaning and the time of milking. 

8. Ventilation. — The cow stables shall be provided with adequate ventilation 
either by means of some ap])roved artificial device, or by the substitution of 
cheesecloth for glass in the windows, each cow to be provided with a minimum 
of 000 cubic feet of air space. 

9. Windows. — A sufficient number of wind'ows shall be installed and so dis- 
tributed as to provide satisfactory light and a maximum of sunshine. 2 feet 

25 



26 BULLETIN 1, U. S. DEPARTMENT OF AGRICULTUEE. 

square of window area to each 600 cubic feet of air space to represent the 
minimum. The coverings of such windows shall be kept free from dust and 
dirt. 

10. Exclusion of flies, etc. — All necessary measures should be taken to prevent 
the entrance of flies and other insects and rats and other vermin into all the 
buildings. 

11. Exclusion of animals from the herd. — No horses, hogs, dogs, or otlier ani- 
mals or fowls shall be allowed to come in contact with the certified herd, either 
in the stables or elsewhere. 

12. Bedding. — No dusty or moldy hay or straw, bedding from horse stalls, 
or other unclean materials shall be used for bedding the cows. Only bedding 
which is clean, dry, and absorbent may be used, preferably shavings or straw. 

13. Clentiing stable and dispnital of manure. — Soiled bedding and manure shall 
be removed at least twice daily, and the floors shall be swept and kept free 
from refuse. Such cleaning shall be done at least one hour before the milking 
time. Manure, when removfed, shall be drawn to the field or temporarily stored 
in containers so screened as to exclude files. Manure shall not be even tempo- 
rarily stored within 300 feet of the barn or dairy building. 

14. Cleaning of cotes. Each cow in the herd shall be groomed daily, and no 
manure, mud, or filth shall be allowed to remain upon her during milking; for 
cleaning, a vacuum apparatus is recommended. 

15. Clipping. — Long hitirs shall be clipped from the udder and fianks of the 
cow and from the tail above the brush. The hair on the tail shall be cut so 
that the brush may be well above the ground. 

16. Cleaning of udders. — The udders and teats of the cow shall be cleaned be- 
fore milking; they shall be washed with a cloth and water, and dry wiped with 
another clean sterilized cloth — a separate cloth for drying each cow. 

17. Feeding. — All foodstuffs shall be kept in an apartment separate from and 
not directly communicating with the cow barn. They shall be brought into the 
barn only immediately before the feeding hour, which shall follow the milking. 

18. Only those foods shall be used which consist of fresh, palatable, or nu- 
tritious materials, such as will not injure the health of the cows or unfavorably 
affect the taste or character of the milk. Any dirty or moldy food or food in 
a state of decomposition or putrefaction shall not be given. 

19. A well-balanced ration shall be used, and all changes of food shall be 
made slowly. The first few feedings of grass, alfalfa, ensilage, green corn, or 
other green feeds shall be given in small rations and increased gradually to 
full ration. 

20. Exercise. — All dairy cows shall be turaed out for exercise at least 2 hours 
in each 24 in suitable weather. Exercise yards shall be kept free from manure 
and other filth. 

21. Washing of hands. — Conveniently located facilities shall be provided for 
the milkers to wash in before and during milking. 

22. The hands of the milkers shall be thoroughly washed with soap, water, 
and brush and carefully dried on a clean towel immediately before milking. 
The hands of the milkers shall be rinsed with clean water and carefully dried 
before milking each cow. The practice of moistening the hands with milk is 
forbidden. > 

23. Milking clothes. — Clean overalls, jumper, and cap shall be worn during 
milking. They shall be washed or sterilized each day and used for no other 
purpose, and when not in use they shall be kept in a clean place, protected from 

dust and dirt. 

24. Things to he avoided by milkers.— WhWe engaged about the dairy or in 
handling the milk employees shall not use tobacco nor intoxicating liquors. 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 27 

They shall keep their fingers away from their nose and mouth, and no milker 
shall permit his hands, fingers, lips, or tongue to come in contact with milk 
intended for sale. 

25. During milking the milkers shall be careful not to touch anything but 
the clean top of the milking stool, the milk pail, and the cow's teats. 

26. Milkers are forbidden to spit upon the walls or floors of stables, or upon 
the walls or floors of milk houses, or into the water used for cooling the milk 
or washing the utensils. 

27. Fore milk. — The first streams from each teat shall be rejected, as this 
fore milk contains large numbers of bacteria. Such milk shall be collected 
into a separate vessel and not milked onto the fioors or into the gutters. The 
milking shall be done rapidly and quietly, and the cows shall be treated kindly. 

2S. MUk and calving period. — Milk from all cows shall be excluded for a 
period of 45 days before and 7 days after parturition. 

29. Bloody and ."^tringi/ milk. — If milk from any cow is bloody and stringy 
or of minatural appearance, the milk from that cow shall be rejected and the 
cow isolated from the herd until the cause of such abnormal appearance has 
been determined and removed, special attention being given in the meantime to 
the feeding or to possible injuries. If dirt gets into the pail, the milk shall be 
discarded and the pail washed before It is used. 

30. Make-up of herd. — No cows except those receiving the same supervision 
and care as the certified herd shall be kept in the same barn or brought in 
contact with them. 

31. Employees other than milkers. — The requirements for milkers, relative to 
garments and cleaning of hands, shall apply to all other i)ersons handling the 
milk, and children unattended by adults shall not be allowed in the daily nor 
in the stable during milking. 

32. Straining and strainers. — Promptly after the milk is drawn it shall be re- 
moved from the stable to a clean room and then emptied from the milk pail to 
the can, being strained through strainers made of a double layer of finely 
meshed cheesecloth or absorbent cotton thoroughly sterilized. Several strainers 
shall be provided for each milking in order that they may be frequently changed. 

33. Dairy building. — A dairy building shall be provided which shall be located 
at a distance from the stable and dwelling prescribed by the local commission, 
and there shall be no hogpen, privy, or manure pile at a higher level or within 
300 feet of it. 

34. The dairy building shall be kept clean and shall not be used for purposes 
other than the handling and storing of milk and milk utensils. It shall be pi'o- 
vided with light and ventilation, and the floors shall be graded and water-tight. 

35. The dairy building shall be well lighted and screened and drained through 
well-trapped pipes. No animals shall be allowed therein. No part of the dairy 
building shall be used for dwelling or lodging purposes, and the bottling room 
shall be used for no other purpose than to provide a place for clean milk uten- 
sils and for handling the milk. During bottling this room shall be entered only 
by persons employed therein. The bottling room shall be kept scrupulously 
clean and free from odors. 

36. Temperature of milk. — Proper cooling to reduce the temperature to 45° F. 
shall be used, and aerators shall be so situated that they can be protected from 
flies, dust, and odors. The milk shall be cooled immediately after being milked, 
and maintained at ;i temperature between 35° and 45° F. until delivered to the 
consumer. 

37. Scaling of bottles. — Milk, after being cooled and bottled, shall be immedi- 
ately sealed in a manner satisfactory to the commission, but such seal shall in- 
clude a sterile hood which completely covers the lip of the bottle. 



28 BULLETIN 1, U. S. DEPARTMENT OP AGRICULTURE. 

38. Cleaning and sterilizing of bottles. — The dairy building shall be provided 
with approved apparatus for the cleansing and sterilizing of all bottles and 
utensils.,used in milk production. All bottles and utensils shall be thoroughly 
cleane(LJ>y hot water and sal soda, or equally pure agent, rinsed until the 
cleaning water is thoroughly removed, then exposed to live steam or boiling 
water at least 20 minutes, and then kept inverted until used, in a place free 
from dust and other contaminating materials. 

39. Utensils. — ^All utensils shall be so constructed as to be easily cleaned. 
The milk pail should preferably have an elliptical opening 5 by 7 inches in 
diameter. The cover of this pail should be so convex as to make the entire 
interior of the pail visible and accessible for cleaning. The pail shall be made 
of heavy seamless tin, and with seams which are flushed and made smooth by 
solder. Wooden pails, galvanized-iron pails, or pails made of rough, porous 
materials, are forbidden. All utensils used in milking shall be kept in good 
repair. 

40. Water supply. — The entire water supply shall be absolutely free from 
contamination, and shall be sufficient for all dairy purposes. It shall be pro- 
tected against flood or surface drainage, and shall be conveniently situated in 
relation to the milk house. 

41. Privies, etc., in relation to icater supply. — Privies, pigpens, manure piles, 
and all other possible sources of contamination shall be so situated on the farm 
as to render impossible the contamination of the water supply, and shall be 
so protected by use of screens and other measures as to prevent their becom- 
ing breeding grounds for flies. 

42. Toilet rooms. — Toilet facilities for the milkers shall be provided and 
located outside of the stable or milk house. These toilets shall be properly 
screened, shall be kept clean, and shall be accessible to wash basins, water, 
nail brush, soap and towels, and the milkers shall be required to wash and dry 
their hands immediately after leaving the toilet room. 

TRANSPORTATION. 

43. In transit the milk packages shall be kept free from dust and dirt. The 
wagon, trays, and crates shall be kept scrupulously clean. No bottles shall be 
collected from houses in which communicable diseases prevail, unless a 
separate wagon is used and under conditions prescribed by the department of 
health and the medical milk commission. 

44. All certified milk shall reach the consumer within 30 hours after milking. 

VETERINARY SUPERVISION OF THE HERD. 

45. Tuhereulin test. — The herd shall be free from tuberculosis, as shown by 
the proper application of the tuberculin test. The test shall be applied in 
accordance with the rules and regulations of the United States Government, 
and all reactors shall be removed immediately from the farm.^ 

46. No new animals shall be admitted to the herd without first having passe^l 
a satisfactory tuberculin test, made in accordance with the rules and regula- 
tions mentioned; the tuberculin to be obtained and applied only by the official 
veterinarian of the commission. 

47. Immediately following the application of the tuberculin test to a herd 
for the purpose of eliminating tuberculous cattle, the cow stable and exercising 
yards shall be disinfected by the veterinary inspector in accordance with the 
rules and regulations of the United States Government. 

1 See Circular of Instructions issued by the Bureau of Animal Industry for making 
tuberculin tests and for disinfection of premises. 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 29 

48. A second tuberculin test shall follow each primary test after an interval 
of six months, and shall be applied in accordance with the rules and regulations 
mentioned. Thereafter, tuberculin tests shall be reapplied annually, but it is 
recommended that the retests be applied semiannually. 

49. Identification of cows.— Each dairy cow in each of the certified herds 
shall be labeled or tagged with a number or mark which will permanently 
identify her. 

50. Herd-book record. — Each cow in the herd shall be registered in a herd 
book, which register shall be accurately kept so that her entrance and de- 
parture from the herd and her tuberculin testing can be identified. 

51> A copy of this herd-book record shall be kept in the hands of the veteri- 
narian of the medical milk commission under which the dairy farm is operating, 
and the veterinarian shall be made responsible for the accuracy of this record. 

52. Dates of tuberculin tests. — The dates of the annual tuberculin tests shall 
be definitely arranged by the medical milk commission, and all of the results 
of such tests shall be recorded by the veterinarian and regularly reported to the 
secretary of the medical milk commission issuing the certificate. 

53. The results of all tuberculin tests shall be kept on file by each medical 
milk commission, and a copy of all such tests shall be made available to the 
American Association of Medical Milk Commissions for statistical purposes. 

54. The "proper designated officers of the American Association of Medical 
Milk Commissions should receive copies of reports of all of the annual, semi- 
annual, and other oflicial tuberculin tests which are made and keep copies of 
the same on file and compile them annually for the use of the association. 

55. Disposition of cows sick ^vith diseases other than tuberculosis. — Cows 
having rheumatism, leucorrhea, inflammation of the uterus, severe diarrhea, or 
disease of the udder, or cows that from any other cause may be a menace to 
the herd shall be removed from the herd and placed in a building separate fi-om 
that which may be used for the isolation of cows with tuberculosis, unless such 
building has been properly disinfected since it was last used for this purpose. 
The milk from such cows shall not be used nor shall the cows be restored to the 
herd until permission has been given by the veterinary inspector after a careful 
physical examination. 

56. Notification of veterinary inspector. — In the event of the occurrence of 
any of the diseases just described between the visits of the veterinary inspector, 
or if at any time a number of cows become sick at one time in such a way as to 
suggest the outbreak of a contagious disease or poisoning, it shall be the duty of 
the dairyman to withdraw such sickened cattle from the herd, to»destroy their 
milk, and to notify the veterinary inspector by telegraph or telephone imme- 
diately. 

57. Emaciated coics. — Cows that are emaciated from chronic diseases or from 
any cause that in the opinion of the veterinai'y inspector may endanger the 
quality of the milk, shall be removed from the herd. 

BACTERIOLOGICAL STANDARDS. 

58. Bacterial counts. — Certified milk shall contain less than 10,000 bacteria 
per cubic centimeter when delivered. In case a count exceeding 10,000 bacteria 
per cubic centimeter is found, daily counts shall be made, and if normal counts 
are not restored within 10 days the certificate shall be suspended. 

59. Bacterial counts shall be made at least once a week. 

60. Collection of samples. — The samples to be examined shall be obtained 
from milk as offered for sale and shall be taken by a representative of the milk 
commission. The samples shall be received in the original packages, in prop- 



30 BULLETIN 1, U. S. DEPARTMENT OF AGRICULTUEE. 

erly iced coutciiners, aud tliey shall be so kept luitil examined, so as to limit 
as far as possible changes in their bacterial content. 

61. For the purpose of ascertaining the temperature, a separate original 
package shall be used, and the temperature taken at the time of collecting the 
sample, using for the purpose a standardized thermometer graduated in the 
centigrade scale. 

62. Interval hetween milking and plating. — The examinations shall be made 
as soon after collection of the samples as possible, and in no case shall the 
interval between milking and plating the samples be longer than 40 hours. 

63. Plating. — The packages shall be opened with aseptic precautions after the 
milk has been thoroughly mixed by vigorously reversing and shaking the con- 
tainer 25 times. 

64. Two plates at least shall be made for each sample of milk, and there 
shall also be made a control of each lot of medium and apparatus used at each 
testing. The plates shall be gi'own at 37° C. for 48 hours. 

65. In making the plates there shall be used agar-agar media containing 1.5 
per cent agar and giving a reaction of 1.0 to phenolphthalein. 

The following is the method recommende<l by a committee of the American 
Public Health Association for the making of the media, modified, however, as to 
the agar content and reaction to conform to the requirements specified in 
section 65 : 

1. Boil 15 grams of thread agar in 500 c. c. of water for half an hour and 
make up weight to 500 grams or digest for 10 minutes in the autoclave at 
110° C. I>et this cool to about 60° C. 

2. Infuse 500 grams finely chopped lean beef for 24 hours with its own weight 
of distilled water in the refrigerator. 

3. Make up any loss by evaporation. 

4. Strain infusion through cotton flannel, using pressure. 

5. Weigh filtered infusion. 

6. Add Witte's peptone. 2 per cent. 

7. Warm on water bath, stirring until peptone is dissolved and not allowing 
temperature to rise above 60° C. 

S. To the 500 grams of meat infusion (with pei)tone) add 500 grams of the 
2 per cent agar, keeping the temperature below 60° C. 
0. Heat over boiling water (or steam) bath 30 minutes. 

10. Restore weight lost by evaporation. 

11. Titrate after boiling one minute to expel carbonic acid. 

12. Adjust reaction to final point desiretl +1 by adding normal sodium 
hydrate. 

13. Boil two minutes over free flame, constantly stirring. 

14. Restore weight lost by evaporation. 

15. Filter through absorbent cotton or coarse filter paper, passing the filtrate 
through the filter repeatedly until clear. 

16. Titrate and record the final reaction. 

17. Tube (10 c. c. to a tube) and sterilize in autoclave one hour at 15 pounds 
l)ressure or in the streaming steam for 20 minutes on three successive days. 

66. Samples of milk for plating shall be diluted in the proportion of 1 part of 
milk to DO parts of sterile water; shake 25 times and plate 1 c. c. of the 
dilution. 

The committee on bacterial milk analyses of the American Public Health 
Association in Part IV of its report presented details with respect to plating 
apparatus and technique in part as follows : 

Plating apparatus. — For plating it is best to have a water bath in which to 
melt the media and a water-jacketed water bath for keeping it at the required 
temperature; a wire rack which should fit both the water baths for holding the 
media tubes ; a thermometer for recording the temperature of the water in the 
water- jacketed bath, sterile 1 c. c. pipettes, sterile Petri dishes, and sterile dilu- 
tion water in measured quantities. 

Dilutions. — Ordinary potable water, sterilized, may be used for dilutions. 
Occasionally spore forms are found in such water which resist ordinary auto- 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 31 

clave sterilization ; in such eases distilled water may be used or the auto- 
clave pressure increased. With dilution water in S-ounce bottles calibrated for 
99 cubic centimeters * * * all the necessary dilutions may be made. 

Short, wide-mouthed "blakes" or wide-mouthed French square bottles are 
more easily handled and more economical of space than other forms of bottles 
or flasks. 

Eight-ounce bottles are the best, as the required amount of dilution water 
only about half fills them, leaving room for shaking. Long-fiber nouabsorbeut 
cotton sliould be used for plugs. It is well to use care in selecting cotton for 
this purpose to avoid short-fiber or dusty cotton, which give a cloud of lint-like 
particles on shaking. Bottles * * * should be filled a little over the 99 
c. c. * * * to allow for loss during sterilization. 

Pipettes. — Straight sides 1 c. c. pipettes are more easily handled than those 
with bulbs: they may be made from ordinary three-sixteenths inch glass tubing 
and should be about 10 inches in length. 

Plating technique.: — The agar after melting should be kept in the water- 
jacketed water bath between 40° C and 45° C. for at least 15 minutes before 
using to make sure that the agar itself has reached the temperature of the 
surrounding water. If used too warm the heat may destroy some of the bacteria 
or retard their growth. 

Shake the milk sample 25 times, then with a sterile pipette transfer 1 c. c. to 
the first dilution water and rinse the pipette by drawing dilution water to the 
mark and expelling; this gives a dilution 1 to 100. 

* * * Then with a sterile pipette transfer 1 c. c. to the Petri dish, using 
care to raise the cover only as far as necessary to insert the end of the pipette. 

Take the tube of agar from the water bath, wipe the water from outside the 
tube with a piece of cloth, remove the plug, pass the mouth of the tube through 
a flame, and pour the agar into the plate, using the same care as before to 
avoid exposure of the plate contents to the air. 

Carefully and thoroughly mix the agar and diluted milk in the Petri dish by 
a rotary motion, avoiding the formation of air bubbles or slopping the agar, 
and after allowing the agar to harden for at least 15 minutes at room tempera- 
ture, place the dish bottom down in the incubator. 

Plating should always be done in a place free from dust or currents of air. 

In order that colonies may have sufficient food for proper development 10 c. c. 
of agar shall be used for each plate. 

67. Determination of taste and odor of milk. — After the plates have been pre- 
pared and placed in the incubator, the taste and odor of the milk shall be deter- 
mined after warming the milk to 100° F.^ 

68. Counts. — The total number of colonies on each plate should be counted, 
and the results expressed in multiples of the dilution factor. Colonies too 
small to be seen with the naked eye or with slight magnification shall not be 
considered in the count. 

69. Records of Mcteriologic tests. — The results of all bacterial tests shall be 
kept on file by the secretary of each commission, copies of which should be 
made available annually for the use of the American Association of Medical 
Milk Commissions. 

CHEMICAL STANDARDS AND METHODS. 

The methods that must be followed in carrying out the chemical investiga- 
tions essential to the protection of certified milk are so complicated that in 
order to keep the fees of the chemist at a reasonable figure, there must be 
eliminated from the examination those procedures which, whilst they might be 
helpful and interesting, are in no sense necessary. 

For this reason the determination of the water, the total solids and the 
milk sugar is not required as a part of the routine examination. 

70. The chemical analyses shall be made by a competent chemist designated 
by the medical milk commission. 

1 Should it be deemed desirable and necessary to conduct tests for sediment, the pres- 
ence of special bacteria, or the number of leucocytes, the methods adopted by the com- 
mittee of the American Public Health Association should be followed. 



32 BULLETIN 1, U. S, DEPAETMENT OF AGRICULTURE. 

71. Method.of obtaining samples. — The samples to be examined by the chemist 
shall have been examined previously by the bacteriologist designated by the 
medical milk commission as to temperature, odor, taste, and bacterial content. 

72. Fat standards. — The fat standard for certified milk shall be 4 per cent, 
with a permissible range of variation of from 3.5 to 4.5 per cent. 

73. The fat standard for certified cream shall be not less than 18 per cent. 

74. If it is desired to sell higher fat-percentage milks or creams as certified 
milks or creams, the range of variation for such milks shall be 0.5 i)er cent on 
either side of the advertised percentage and the range of variations for such 
creams shall be 2 per cent on either side of the advertised percentage. 

75. The fat content of certified milks and creams shall be determined at 
least once each month. 

76. The methods recommended for this purpose are the Babcoek (a), the 
Leffmann-Beam (&), and the Gerber (c). 

(a) Babcoek test. — The Babcoek test is based on the fact that strong sul- 
phuric acid v^'ill dissolve the nonfatty solid constituents of milk, and thus enable 
the fat to separate on standing. It can be conducted by any of the Babcoek 
outfits which are purchasable in the market. 

" The test is made by placing in the special test bottle 18 grams (17.6 c. c. ) of 
milk. To this is added, from a pipette, burette, or measuring bottle, 17.5 c. c. 
commercial sulphuric acid of a specific gravity of 1.S2 to 1.83. The contents of 
the bottle are carefully and thoroughly mixed by a rotary motion. The mix- 
ture becomes brown and heat is generated. The test bottle is now placed in a 
properly balanced centrifuge and whirled for 5 minutes at a speed of from 800 
to 1,200 revolutions per minute. Hot water is then added to fill the bottle to 
the lower part of the neck, after which it is again whirled for two minutes. 
Now, enough hot water is added to float the column of fat into the graduated 
portion of the neck of the bottle, and the whirling is repeated for a minute. 
The amount of fat is read while the neck of the bottle is still hot. The read- 
ing is from the upper limits of the meniscus. A pair of calipers is of assistance 
in measuring the column of fat." (Jensen's Milk Hygiene, Leonard Pearson's 
translation.) 

(b) Lcffmann-Bcam test. — The distinctive feature is the use of fusel oil. the 
effect of which is to produce a greater difference in surface tension between the 
fat and the liquid in which it is suspended, and thus promote its readier sepa- 
ration. This effect has been found to be heightened by the presence of a small 
amount of hydrochloric acid. 

The test bottles have a capacity of about 80 c. c. and are provided with a 
graduated neck, each division of which represents 9.1 per cent by weight of 
butter fat. 

Fifteen centimeters of the milk are measured into the bottle, 3 c. c. of a 
mixture of equal parts of amyl alcohol and strong hydrochloric acid added and 
mixed. Then 9 c. c. of concentrated sulphuric acid is added in portions of 
about 1 c. c. ; after each addition the liquids are mixed by giving the bottle a 
gyratory motion. If the fluid has not lost, all of its milky color by this treat- 
ment, a little more concentrated acid must be added. The neck of the bottle is 
now inmiediately filled at about the zero point with one part sulphuric acid 
and two parts water, well mixed just before using. Both the liquid in the bot- 
tle and the diluted acid mu.st be hot. The bottle is then placed at once in the 
centrifugal machine; after rotation from one to two minutes, the fat will col- 
lect in the neck of the bottle and the percentage may be read off. 

(e) Gerber's test. — This test is applied as follows: The test bottles are put 
into the stand with the mouths uppermost; then, with the pipette designed for 
the purpose, or with an automatic measurer, 10 c. c. of sulphuric acid are 
filled into the test bottle, care being taken not to allow any to come in contact 
with the neck. Tlie few drops remaining in the tip of the pipette should not 
be blown out. Then 11 c. c. of milk are measured with the proper pipette and 
allowed to flow slowly onto the acid, so that the two liquids mix as little as 
possible. Finally, the amyl alcohol is added. (It is important to use the re- 
agents in the proper order, which is — sulphuric acid, milk, amyl alcohol. If 
the sulphuric acid is followed by amyl alcohol and the milk last, then the 
result is sometimes incorrect.) A rubber stopper, which must not be damaged, 
is then fitted into the mouth, of the test bottle, and the contents are well shaken, 



MEDICAL MILK COMMISSIONS AND CEKTIFIED MILK. 33 

the thumb being kept on the stopper to prevent it coming out. As a consider- 
able amount of heat is generated by the action of the sulphuric acid on the 
milk, the test bottle should be wrapped in a cloth. 

The shaking of the sample must be done thoroughly and quickly, and the 
test bottle inverted several times, so that the liquid in the neck becomes thor- 
oughly mixed. By pressing in the rubber stopper the height of the liquid can 
be brought to about the zero point on the scale. 

If only a few samples have to be analyzed and the room is warm, the test 
botttles can be put into tlie centrifuge without any preliminary heating, other-' 
wise the test bottles must be warmed for a few minutes (not longer) in the 
water bath at a temperature of 60° to 65° C. When the temperature rises 
higher than this, say above 70° C, the rubber stopper is liable to be blown out 
of the test bottle. After the test bottles have been heated they are arranged 
symmetrically in the centrifuge and whirled for 3 to 4 minutes at a speed of 
about 1,000 revolutions per minute. When the centrifuge has a heating ar- 
rangement attached to it, the preliminary warming is not, of course, necessary. 
When the test bottles are taken out of the centrifuge, they are again placed 
in the water bath at a temperature of 60° to 65° C, and left there for several 
minutes before being read; where the centrifuge is heated, the tubes can be 
read off as taken from the centrifuge. 

By carefully screwing in the rubber stopper, or even by pressing it, the lower 
limit of the fat column is brought onto one of the main divisions of the scale, 
and then, by holding the test bottle against the light, the height of the column 
of fat can be accurately ascertained. The lowest point of the meniscus is taken 
as the level when reading the upper surface of the fat in a sample of whole milk, 
and the middle of the meniscus for separated milk. 

If the column of fat is not clear and sharply defined, the sample must be 
again whirled in the centrifuge. 

Each division on the scale is equivalent to 0.1 per cent, so it is very easy to 
read to 0.05 per cent, or, with a lens, to 0.025 per cent. If the number which is 
read off is multiplied by 0.1, then the percentage quantity of fat in the milk is 
obtained; e. g., if the number on the scale was 36.5, then the percentage of fat is 
3.65. (Milk and Dairy Products, Barthel ; translated by Goodwin, p. 71.) 

77. Before condemning samples of milk which have fallen outside the limits 
allowed, the chemist shall have determined, by control ether extractions, that 
his apparatus and his technique are reliable. 

78. Protein standard. — The protein standard for certified milk shall be 3.50 
per cent, with a permissible range of variation of from 3 to 4 per cent. 

79. The protein standard for certified cream shall correspond to the protein 
standard for certified milk. 

80. The protein content shall be determined only when any special considera- 
tion seems to the medical milk commission to make it desirable. 

81. It shall be determined by the Kjeldahl method, using the Gunning or some 
other reliable modification, and emplojang the factor 6.25 in reckoning the 
protein from the nitrogen. 

Kjeldahl method. — Five cubic centimeters of milk are measured carefully into 
a flat-bottom 800 c. c. Jena flask, 20 c. e. of concentrated sulphuric acid (C. P.; 
sp. gr., 1.84) are added, and 0.7 gram of mercuric oxid (or its equivalent in 
metallic mercury) ; the mixture is then heated over direct flame until it is straw- 
colored or perfectly white; a few crystals of potassium permanganate are now 
added till the color of the liquid remains green. All the nitrogen in the milk 
has then been converted into the form of ammonium sulphate. After cooling. 
200 c. c. of ammonia-free distilled water are added, 20 c. c. of a solution of 
potassium sulphide (containing 40 grams sulphide per liter), and a fraction of 
a gram of powdered zinc. A quantity of semi-normal HCl solution more than 
sufficient to neutralize the ammonia obtained in the oxidation of the milk is 
now carefully measured out from a delicate burette (divided into ^ c. c.) 
into an Erlenmeyer flask and the flask connected with a distillation apparatus. 
At the other end the Jena flask containing the watery solution of the am- 
monium sulphate is connected, after adding 50 c. c. of a concentrated soda solu- 
tion (1 pound " pure potash " dissolved in 500 e. c. of distilled water and allowed 



34 BULLETIN 1, U. S. DEPAKTMENT OF AGRICULTUEE. 

to settle) ; the contents of the Jena flask are now heated to boiling, and. the dis- 
tillation is continued for 40 minutes to an hour, until all ammonia has been dis- 
tilled over. 

The excess of acid in the Erlenmeyer receiving flask is then accurately 
titi'ated back by means of a tenth-normal standard ammonia solution, using a 
cochineal solution as an indicator. From the amount of acid used the per cent 
of nitrogen is ob*^ainod; and from it the per cent of casein and albumen in 
the milk by multiplying by 6.25. The amount of nitrogen contained in the 
chemicals used is determined by blank experiments and deducted from the nitro- 
gen obtained as described. (Farrington and Woll, Testing Milk and Its 
Products, p. 221.) 

52. Coloring matter and preservatives. — All certified milks and creams shall 
be free from adulteration, and coloring matter and preservatives shall not be 
added thereto. 

53. Tests for the detection of added coloring matter shall be applied whenever 
the color of the milk or cream is such as to arouse suspicion. 

Test for colorinfj matter. — The presence of foreign coloruig matter in milk is 
easily shown by shaking 10 c. c. of the milk with an equal quantity of ether; 
on standing, a clear ether solution will rise to the surface; if artificial coloring 
matter has been added to the milk, the solution will be yellow colored, the 
intensity of the color indicating the quantity added; natural fresh milk will 
give a colorless ether solution. (Testing Milk and Its Products. Farrington and 
Woll, p. 244.) 

84. Tests for the detection of formaldehyde, borax, and boracic acid shall 
be applied at least once each month. Occasionally application of tests for the 
detection of salicylic acid, benzoic acid, and the benzoates is also recommended. 

Test for the deteetion of formaldehyde. — Five cubic centimeters of milk is 
measured into a white porcelain dish, and a similar quantity of water added ; 
10 c. c. of HCl. containing a trace of Fe- CU, is added, and the mixture is heated 
very slowly. If formaldehyde is present, a violet color will be formed. (Test- 
ing Milk and Its Products, Farrington and Woll, p. 249.) 

Test for boracie aeid {bora.r, Itorates, preservaline, etc.). — One hundred cubic 
centimeters of milk are made alkaline with a soda or potash solution, and then 
evaporated to dryness and incinerated. The ash is dissolved in water, to which 
a little hydrochloric acid has been added, and the solution filtered. A strip of 
turmeric paper moistened with the filtrate will be colored reddish brovni when 
dried at 100° C. on a watch glass, if boracic acid is present. 

If a little alcohol is poured over the ash to which concentrated sulphuric acid 
has been added, and fire is set to the alcohol, after a little while this will burn 
with a yellowish-green tint, especially noticeable if the ash is stirred with a 
glass rod and when the flame is about to go out. (Testing Milk and Its Prod- 
ucts, Farrington and Woll, p. 247.) 

Test for saUeylic acid (salicylates, etc.). — ^Twenty cubic centimeters of milk 
are acidulated with sulphuric acid and shaken with ether; the ether solution 
is evaporated, and the residue treated with alcohol and a little iron-chlorid solu- 
tion; a deep violet color will be obtained in the presence of salicylic acid. 
(Testing Milk and Its Products. Farrington and Woll, p. 248.) 

Test for benzoic aeid. — ^Two hundred and fifty to five hundred cubic centi- 
meters of milk are made alkaline with a few drops of lime or baryta water, 
and then evaporated to about a quarter of the bulk. Powdered gypsum is 
stirred into the remaining liquid until a paste is formed, which is then dried 
on the water bath. The gypsum only serves to hasten the drying, and pow- 
dered pumice stone or sand can be used equally well. When the mass is dry, 
it is finely powdered and moistened with dilute sulphuric acid and shaken out 
three or four times with about twice the volume of 50 per cent alcohol, in 
which benzoic acid is easily soluble in the cold, the fat only being dissolved to 
a vei'y slight extent or not at all. The acid alcoholic liquid from the various 
extractions, which contains milk sugar and inorganic salts in addition to the 
benzoic acid, is neutralized with baryta water and evaporated to a small bulk. 
Dilute sulphuric acid is again added, and the liquid shaken out with small quan- 
tities of ether. On evaporation of the ether, the benzoic acid is left behind in 
almost pure state, the only impurities being small quantities of fat or ash. 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 35 

The benzoic acid wliich is obtained is dissolved in a small quantity of warm 
water, a drop of sodium acetate and neutral ferric chloride added, and the red 
precipitate of benzoate of iron indicates the presence of the acid. ( Milk and 
Dairy Products. Barthel ; translated by Goodwin, p. 121.) 

85. Detection of heated milk. — Certified milk or cream shall not be subjected 
to heat unless specially directed by the commission to meet emergencies. 

86. Tests to determine whether such milks and creams have been subjected 
to heat shall be applied at least once each month. 

Detection of heated milk — Storch's tnethod. — Five cubic centimeters of milk 
are poured into a test tube; a drop of weak solution of hydrogen dioxide (about 
0.2 i>er cent) which contains about 0.1 per cent suljihuric acid, is i,dded, and 
two drops of a 2 per cent solution of paraphenylendiamin (solution should be 
renewed quite often), then the fluid is shaken. If the milk or the cream be- 
comes, at once, indigo blue, or the whey violet or reddish brown, then this has 
not been heated or. at all events, it has not been heated higher than 78° C. 
(172.5° F. ) ; if the milk becomes a light bluish gi'ay immediately or in the 
course of half a minute, then it has been heated to 70° to S0° C. (174.2° to 
176° F. ). If the color remains white, the milk has been heated at least to 80° 
C. (176° F. ). In the examination of sour milk or sour buttermilk, lime water 
must be added, as the color reaction is not shown in acid solution. 

Arnold's giiaiac method. — A little milk is poured into a test tube and a little 
tincture of guaiac is added, drop by drop. If the milk has not been heated to 
80° C. (176° F.) a blue zone is formed between the two fluids; heated milk 
gives no reaction, but remains white. The guaiac tincture should not be used 
perfectly fresh, but should have stood a few days and its potency have been 
determined. Thereafter it can be used indefinitely. These tests for heated milk 
are only active in the case of milks which have been heated to 176° F. or 80° C. 
(Jensen's Milk Hygiene. Pearson's translation, p. 192.) 

Microscopic test for healed {pasteurized) milk — Frost and Ravenel. — About 
15 c. c. of milk are eentrifuged for 5 minutes, or long enough to throw down the 
leucocj-tes. The cream layer is then completely removed with absorbent cotton 
and the milk drawn oft" with a pipette, or a fine-pointed tube attached to a Chap- 
man air pump. Only about 2 mm. of milk are left above the sediment which is 
in the bottom of the sedimentation tube. 

The stain, which is an aqueous solution of safranin 0, soluble in water, is then 
added very slowly from an opsonizing pipette. The important thing is to mix 
stain and milk so slowly that clotting does not take place. The stain is added 
until a deep opaque rose color is obtained. After standing 3 minutes, by means 
of the opsonizing pipette, which has been washed out in hot water, the stained 
sediment is then transferred to slides. A small drop is placed at the end of each 
of several slides and spread by means of a glass spreader, as in Wright's method 
for opsonic index determinations. 

In an unheated milk the polymorphonuclear leucocytes have their protoplasm 
slightly tinged or are unstained. 

In heated milk the polymorphonuclear leucocytes have their nuclei stained. 
In milk heated to 63° C. or above, practically all of the leucocytes have their 
nuclei definitely stained. When milk is heated at a lower temperature the 
nuclei are not a"ll stained above 60° C. The majority, however, are stained. 

87. Specific gravity. — The specific gravity of certified milk shall range from 
1.029 to 1.034. 

88. The specific gravity shall be determined at least each month. 

The Quevenne lactodensimeter is recommended for the determination of the 
specific gravity. It is made like an ordinary aerometer and divided into degrees 
which correspond to a specific gravity from 1.014 to 1.040. or only 1.022 to 1.038, 
since by the latter division a greater space is gained between the different 
degrees without unduly lengthening the instrument. From such a lactoden- 
simeter one can easily read off four decimal places. 

The milk the specific gravity of which is to be determined is well shaken and 
poured into a high glass cylinder of suitable diameter ; the aerometer is dropped 
in slowly, in order to preVent its bobbing up and down. (The bulb should be 
free from adhering air bubbles.) The figures on the stem are the second and 
third decimals of ffie numbers of the specific gravity, so that 34 is to be read 
1.034. For this examination, the temperature of the milk must be 15 C. 



36 BULLETIN 1, U. S. DEPAETMENT OF AGRICULTURE. 

(60° F.) ; if it is not, the specific gravity of the millv at 15° C. must be calcu- 
lated from the specific jjravity found and from the temperature, for in milk 
Inspection and analysis this is the standard. 

METHODS AND REGULATIONS FOR THE MEDICAL EXAMINATION OF EMPLOYEES 
THEIR HEALTH AND PERSONAL HYGIENE. 

89. A medical oQicer. known as the attending dairy physician, shall be selected 
by the commission, who should reside near the dairy producing certified milk. 
He shall be a physician in good standing and authorize<i by law to practice 
medicine; he shall be responsible to the commission and subject to its direction. 
In case more than one dairy is under the control of the commission and they are 
in different localities, a separate physician should be designated for employment 
for the supervision of each dairy. 

90. Before any person shall come on the premises to live and remain as an 
employee, such person, before being engaged in milking or the handling of milk, 
shall be subjected to a complete physical examination by the attending physi- 
cian. No person shall be employed who kas not been vaccinated recently or 
who upon examination is found to have a sore throat, or to be suffering from 
any form of tuberculosis, venereal disease, conjunctivitis, diarrhea, dysentery, 
or who has recently had tyi^hoid fever or is proved to be a typhoid carrier, or 
who has any inflammatory disease of the respiratory tract, or any supiDurative 
process or infectious skin eruption, or any disease of an infectious or contagious 
nature, or who has recently been associated with children sick with contagious 
disease. 

91. In addition to ordinary habits of personal cleanliness all milkers shall 
have well-trimmed hair, wear close-fitting caps, and have clean-shaven faces. 

92. When the milkers live upon the premises their dormitories shall be con- 
structed and operated according to plans approved by the commission. A 
separate bed shall be provided for each milker and each bed shall be kept sup- 
plied with clean bedclothes. Proper bathing facilities shall be provided for all 
employees on the dairy premises, preferably a showier bath, and frequent bathing 
shall be enjoined. 

93. In case the employees live on the dairy premises a suitable building shall 
be provided to be used for the isolation and quarantine of persons under sus- 
picion of having a contagious disease. 

The following plan of construction is recommened : 

The quarantine building and hospital should be one story high and contain at 
least two rooms, each with a caiiacity of about 6,000 cubic feet and containing 
not more than three beds each, the rooms to be separated by a closed partition. 
The doors opening into the rooms should be on opposite sides of the building and 
provided with locks. The windows should be barred and the sash should be at 
least 5 feet from the ground and constructed for proper ventilation. The walls 
should be of a material which will allow proper disinfection. The floor should 
be of painted or washable wood, preferably of concrete, and so constructed that 
the floor may be flushed and properly disinfected. Proper heating, lighting, and 
ventilating facilities should be provided. 

94. In the event of any Illness of a suspicious nature the attending physician 
shall immediately quarantine the suspect, notify the health authorities and the 
secretary of the commission, and examine each member of the dairy force, and 
in every inflammatory affection of the nose or throat occurring among the 
employees of the dairy, in addition to carrying out the above-mentioned pro- 
gram, the attending physician shall take a culture and have it examined at once 
by a competent bacteriologist ai^proved by the commission. Pending such exam- 
ination, the affected employee or employees shall be quarantined. 

95. It shall be the duty of the secretary, on receiving notice of any suspicious 
or contagions disease at the dairy, at once to notify the committee having in 
charge the medical supervision of employees of the dairy farm upon which such 



MEDICAL MILK COMMISSIONS AND CERTIFIED MILK. 37 

disease has developed. Ou receipt of the notice this committee shall assume 
charge of the matter, and shall have power to act for the commission as its 
judgment dictates. As soon as possible thereafter, the committee shall notify 
the commission, through its secretary, that a special meeting may be called for 
ultimate consideration and action. 

96. When a case of contagious disease is found among the employees of a 
dairy producing certified milk under the control of a medical milk commission, 
such employee shall be at once quarantined and as soon as possible removed 
from the plant, and the premises fumigated. 

When a case of contagion is found on a certified dairy it is advised that a 
printed notice of the facts shall be sent to every householder using the milk, 
giving in detail the precautions taken by the dairyman under the direction of 
the commission, and it is further advised that all milk produced at such dairy 
shall be heateil at 145° F. for 40 minutes, or 155° F. for 30 minutes, or 167° F. 
for 20 minutes, and immediately cooled to 50° F. These facts should also be 
part of the notice, and such heating of the milk should be continued during the 
accepted period of incubation for such contagious disease. 

The following method of fumigation is recommended: 

After all windows and doors are closed and the cracks sealed by strips of 
paper applied with flour paste, and the various articles in the room so hung 
or placed as to be exposed on all sides, preparations should be made to generate 
formaldehyde gas by the use of 20 ounces of formaldehyde and 10 ounces of 
permanganate of potash for every 1,000 cubic feet of space to be disinfected. 

For mixing the formaldehyde and potassium permanganate a large gal- 
vanized-iron pail or cylinder holding at least 20 quarts and having a flared 
top should be used for mixing therein 20 ounces of formaldehyde and 10 ounces 
of permanganate. A cylinder at least 5 feet high is suggested. The containers 
should be placed about in the rooms and the necessary quantity of permanga- 
nate weighed and placed in them. The formaldehyde solution for each pail 
should then be measured into a widemouthed cup and placed by the pail in 
which it is to be used. 

Although the reaction takes place quickly, by making preparations as advised 
all of the pails can be " set off" promptly by one person, since there is nothing 
to do but pour the formaldehyde solution over the permanganate. The rooms 
should be kept closed for four hours. As there is a slight danger of fire, the 
reaction should be watched through a window or the pails placed on a nonin- 
flammable surface. 

97. Following a weekly medical inspection of the emploj'ees, a monthly report 
shall be submitted to the secretary of the medical milk commission, on the same 
recurring date by the examining visiting physician. 

The following schedule, filled out in writing and signed by himself, is recom- 
mended as a suitable form for the attending physician's report: 

This is to certify that, on the dates below indicated, official visits were made 

to the dairy, owned and conducted by of (indicating town 

and State), where careful inspections of the dairy employees were made. 

(a) Number and dates of visits since last report. . 

(6) Number of men employed on the plant. . 

(r) Has a recent epidemic of contagion occurred near the dairy, and what 
was its nature and extent? . 

{(I) Have any cases of contagious or infectious disease occurred among the 
men since the last report? . 

(e) Disposition of such cases. . 

(/) What individual sickness has occurred among the men since the last 
report? . 



{g) Disposition of such cases. . 

(/;) Number of emi)!oyees now quai'antined for sickness. . 

(i) Describe the personal hygiene of the men employed for milking when 

prepared for and during the process of milking. . 

(y) What facilities are provided for sickness in employees? 



(A-) General hygienic condition of the dormitories or houses of the em- 
ployees. — . 

(Z) Suggestions for improvement. — , 



38 BULLETIN 1, U. S. DEPARTMENT OF AGRICULTUEE. 

(m) What is the hygienic condition of the employees and their surround- 
ings ? , 

( n ) How many employees were examined at each of the foregoing 
visits? . 

(o) Remarks. 

Attending Physician. 
Date. . 



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